Mental Illness, A Taboo That Needs to Be Addressed

Mental illness has always been a taboo subject in Black communities, kept behind closed doors, viewed as “family business” and swept under the rug.

Some say it is more stigmatized than HIV/AIDS. African Americans comprise 14 percent of the United States population but more than 25 percent of the nation’s mental health needs.

Itis past time to begin reshaping and reinvigorating the public conversation on Black mental health.

Intent on shining a light in the darkness of shame and stigma, Alameda County’s Behavioral Health Care Services held a luncheon for over 100 mental health provides/case managers, educators and administrations, consumers, families members attended. It was part of a full day of speakers, workshops, addressing the disparity of the over-utilization of services; higher rates of recidivism and poor outcomes African Americans are facing around mental health.

Carl C. bell, M.D, former president/CEO of the Mental Health council in Chicago, IL., was the keynote speaker. He offered insights and support towards meeting goals to reduce mental health disparities for the African American community, following the recommendations outlined in a 2010 Alameda County African American Utilization Report.

“You’re already doing the work”, Bell told the packed audience.

“Rebuild the village, culture helps people flourish,” says Bell. “We need cultural and spiritual nuances, beliefs, practices and norms specific to the African American community. These should be incorporated into the planning, delivery and outcomes of mental health and co-occurring conditions services for this community”.

Over the past 30 years, Black male suicide rates have climbed by more than 200 percent. The depression rate among Black women is 50 percent higher than their white women.

Many African-Americans have a lot of negative feelings about mental health services, and many are not even aware of the mental health services that exist. They do not know the symptoms of many mental disorders, or they may believe that mental illness is a sign of weakness or of a character fault.

Blacks are a particularly high-risk population due to their over-representation within a context of social misery. Currently, Blacks account for 40 percent of the country’s homeless population and nearly 50 percent of the prison population.

Black children represent nearly 50 percent of all foster care and adoption cases. Additionally, almost 25 percent of Black youth are exposed to enough violence to meet the diagnostic criteria for post-traumatic stress disorder.

The fields of psychology and psychiatry historically have sometimes played a very negative role in the diagnosis of African-Americans and in the general sort of racist orientation towards African-Americans and their problems.

The stigma thus comes from two directions, from the community and at times from the professions themselves.

For example, how will professional react If a Black man tells his therapist that every time he’s stopped by a police officer, he gets very anxious and nervous and thinks something bad is going to happen? Would the patient be considered paranoid? If the professional does not understand the social reality in which the patient lives, the possibility is there for misunderstanding.

Exacerbating this problem, only 2 percent of psychologists and percent of social workers in the U.S. are African Americans. So an emphasis on cultural competence and trying to get therapists to be aware of the role that culture and social context can play in treatment is a very important thing.

African Americans tend to rely on family, religious and social communities for emotional support rather than turning to health care. When the church plays a role, it can be a very positive force in the community, which has been seen. People who are more spiritually inclined often have better outcomes.

If folks get the appropriate treatment, they can have good outcomes.

Now is time to address the structural issues can contribute to Black mental health. Now is the time to spotlight the connection between mental health and other social problems plaguing the Black community.

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